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1. Histologic and Clinical Factors Associated with Kidney Outcomes in IgA Vasculitis Nephritis

Author

Barbour, S, Coppo, R, Er, L, Pillebout, E, Russo, M, Alpers, C, Fogo, A, Ferrario, F, Jennette, J, Roberts, I, Cook, H, Ding, J, Su, B, Zhong, X, Fervenza, F, Zand, L, Peruzzi, L, Lucchetti, L, Katafuchi, R, Shima, Y, Yoshikawa, N, Ichikawa, D, Suzuki, Y, Murer, L, Wyatt, R, Nelson, R, Narus, J, Wenderfer, S, Geetha, D, Daugas, E, Monteiro, R, Nakatani, S, Mastrangelo, A, Nuutinen, M, Koskela, M, Weber, L, Hackl, A, Pohl, M, Pecoraro, C, Tsuboi, N, Yokoo, T, Takafumi, I, Fujimoto, S, Conti, G, Santoro, D, Materassi, M, Zhang, H, Shi, S, Liu, Z, Tesar, V, Maixnerova, D, Avila-Casado, C, Bajema, I, Barreca, A, Becker, J, Comstock, J, Cornea, V, Eldin, K, Hernandez, L, Hou, J, Joh, K, Lin, M, Messias, N, Muda, A, Pagni, F, Diomedi-Camassei, F, Tokola, H, D’Armiento, M, Seidl, M, Rosenberg, A, Sannier, A, Soares, M, Wang, S, Zeng, C, Haas, M, Barbour, Sean J., Coppo, Rosanna, Er, Lee, Pillebout, Evangeline, Russo, Maria Luisa, Alpers, Charles E., Fogo, Agnes B., Ferrario, Franco, Jennette, J. Charles, Roberts, Ian S. D., Cook, H. Terence, Ding, Jie, Su, Baige, Zhong, Xuhui, Fervenza, Fernando C., Zand, Ladan, Peruzzi, Licia, Lucchetti, Laura, Katafuchi, Ritsuko, Shima, Yuko, Yoshikawa, Norishige, Ichikawa, Daisuke, Suzuki, Yusuke, Murer, Luisa, Wyatt, Robert J., Nelson, Raoul D., Narus, JoAnn H., Wenderfer, Scott, Geetha, Duvuru, Daugas, Eric, Monteiro, Renato C., Nakatani, Shinya, Mastrangelo, Antonio, Nuutinen, Matti, Koskela, Mikael, Weber, Lutz T, Hackl, Agnes, Pohl, Martin, Pecoraro, Carmine, Tsuboi, Nobuo, Yokoo, Takashi, Takafumi, Ito, Fujimoto, Shouichi, Conti, Giovanni, Santoro, Domenico, Materassi, Marco, Zhang, Hong, Shi, Sufang, Liu, Zhi-Hong, Tesar, Vladimir, Maixnerova, Dita, Avila-Casado, Carmen, Bajema, Ingeborg, Barreca, Antonella, Becker, Jan U., Comstock, Jessica M., Cornea, Virgilius, Eldin, Karen, Hernandez, Loren Herrera, Hou, Jean, Joh, Kensuke, Lin, Mercury, Messias, Nidia, Muda, Andrea Onetti, Pagni, Fabio, Diomedi-Camassei, Francesca, Tokola, Heikki, D’Armiento, Maria, Seidl, Maximilian, Rosenberg, Avi, Sannier, Aurélie, Soares, Maria Fernanda, Wang, Suxia, Zeng, Caihong, Haas, Mark, Barbour, S, Coppo, R, Er, L, Pillebout, E, Russo, M, Alpers, C, Fogo, A, Ferrario, F, Jennette, J, Roberts, I, Cook, H, Ding, J, Su, B, Zhong, X, Fervenza, F, Zand, L, Peruzzi, L, Lucchetti, L, Katafuchi, R, Shima, Y, Yoshikawa, N, Ichikawa, D, Suzuki, Y, Murer, L, Wyatt, R, Nelson, R, Narus, J, Wenderfer, S, Geetha, D, Daugas, E, Monteiro, R, Nakatani, S, Mastrangelo, A, Nuutinen, M, Koskela, M, Weber, L, Hackl, A, Pohl, M, Pecoraro, C, Tsuboi, N, Yokoo, T, Takafumi, I, Fujimoto, S, Conti, G, Santoro, D, Materassi, M, Zhang, H, Shi, S, Liu, Z, Tesar, V, Maixnerova, D, Avila-Casado, C, Bajema, I, Barreca, A, Becker, J, Comstock, J, Cornea, V, Eldin, K, Hernandez, L, Hou, J, Joh, K, Lin, M, Messias, N, Muda, A, Pagni, F, Diomedi-Camassei, F, Tokola, H, D’Armiento, M, Seidl, M, Rosenberg, A, Sannier, A, Soares, M, Wang, S, Zeng, C, Haas, M, Barbour, Sean J., Coppo, Rosanna, Er, Lee, Pillebout, Evangeline, Russo, Maria Luisa, Alpers, Charles E., Fogo, Agnes B., Ferrario, Franco, Jennette, J. Charles, Roberts, Ian S. D., Cook, H. Terence, Ding, Jie, Su, Baige, Zhong, Xuhui, Fervenza, Fernando C., Zand, Ladan, Peruzzi, Licia, Lucchetti, Laura, Katafuchi, Ritsuko, Shima, Yuko, Yoshikawa, Norishige, Ichikawa, Daisuke, Suzuki, Yusuke, Murer, Luisa, Wyatt, Robert J., Nelson, Raoul D., Narus, JoAnn H., Wenderfer, Scott, Geetha, Duvuru, Daugas, Eric, Monteiro, Renato C., Nakatani, Shinya, Mastrangelo, Antonio, Nuutinen, Matti, Koskela, Mikael, Weber, Lutz T, Hackl, Agnes, Pohl, Martin, Pecoraro, Carmine, Tsuboi, Nobuo, Yokoo, Takashi, Takafumi, Ito, Fujimoto, Shouichi, Conti, Giovanni, Santoro, Domenico, Materassi, Marco, Zhang, Hong, Shi, Sufang, Liu, Zhi-Hong, Tesar, Vladimir, Maixnerova, Dita, Avila-Casado, Carmen, Bajema, Ingeborg, Barreca, Antonella, Becker, Jan U., Comstock, Jessica M., Cornea, Virgilius, Eldin, Karen, Hernandez, Loren Herrera, Hou, Jean, Joh, Kensuke, Lin, Mercury, Messias, Nidia, Muda, Andrea Onetti, Pagni, Fabio, Diomedi-Camassei, Francesca, Tokola, Heikki, D’Armiento, Maria, Seidl, Maximilian, Rosenberg, Avi, Sannier, Aurélie, Soares, Maria Fernanda, Wang, Suxia, Zeng, Caihong, and Haas, Mark

Abstract

BACKGROUND: Nephritis is a common manifestation of IgA vasculitis and is morphologically indistinguishable from IgA nephropathy. While MEST-C scores are predictive of kidney outcomes in IgA nephropathy, their value in IgA vasculitis nephritis has not been investigated in large multiethnic cohorts. METHODS: Biopsies from 262 children and 99 adults with IgA vasculitis nephritis ( N =361) from 23 centers in North America, Europe, and Asia were independently scored by three pathologists. MEST-C scores were assessed for correlation with eGFR/proteinuria at biopsy. Because most patients ( N =309, 86%) received immunosuppression, risk factors for outcomes were evaluated in this group using latent class mixed models to identify classes of eGFR trajectories over a median follow-up of 2.7 years (interquartile range, 1.2-5.1). Clinical and histologic parameters associated with each class were determined using logistic regression. RESULTS: M, E, T, and C scores were correlated with either eGFR or proteinuria at biopsy. Two classes were identified by latent class mixed model, one with initial improvement in eGFR followed by a late decline (class 1, N =91) and another with stable eGFR (class 2, N =218). Class 1 was associated with a higher risk of an established kidney outcome (time to ≥30% decline in eGFR or kidney failure; hazard ratio, 5.84; 95% confidence interval, 2.37 to 14.4). Among MEST-C scores, only E1 was associated with class 1 by multivariable analysis. Other factors associated with class 1 were age 18 years and younger, male sex, lower eGFR at biopsy, and extrarenal noncutaneous disease. Fibrous crescents without active changes were associated with class 2. CONCLUSIONS: Kidney outcome in patients with biopsied IgA vasculitis nephritis treated with immunosuppression was determined by clinical risk factors and endocapillary hypercellularity (E1) and fibrous crescents, which are features that are not part of the International Study of Diseases of Children classificatio

Published
2024

2. Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update

Author

Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M.L., Roberts, I.S., Bellur, S., Cattran, D., Cook, T.H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Palma, A.M. De, Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Vecchio, L. Del, Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J.C., Wetzels, J.F.M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. Lino, Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., Zoccali, C., Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M.L., Roberts, I.S., Bellur, S., Cattran, D., Cook, T.H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Palma, A.M. De, Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Vecchio, L. Del, Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J.C., Wetzels, J.F.M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. Lino, Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., and Zoccali, C.

Abstract

Contains fulltext : 220672.pdf (Publisher’s version ) (Closed access), BACKGROUND: It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up. METHODS: In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1-10.8)]. RESULTS: In this extended analysis, M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%). CONCLUSION: Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.

Published
2020

3. Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update

Author

Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M.L., Roberts, I.S., Bellur, S., Cattran, D., Cook, T.H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Palma, A.M. De, Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Vecchio, L. Del, Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J.C., Wetzels, J.F.M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. Lino, Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., Zoccali, C., Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M.L., Roberts, I.S., Bellur, S., Cattran, D., Cook, T.H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Palma, A.M. De, Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Vecchio, L. Del, Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J.C., Wetzels, J.F.M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. Lino, Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., and Zoccali, C.

Abstract

Contains fulltext : 220672.pdf (Publisher’s version ) (Closed access), BACKGROUND: It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up. METHODS: In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1-10.8)]. RESULTS: In this extended analysis, M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%). CONCLUSION: Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.

Published
2020

4. Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update

Author

Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M.L., Roberts, I.S., Bellur, S., Cattran, D., Cook, T.H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Palma, A.M. De, Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Vecchio, L. Del, Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J.C., Wetzels, J.F.M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. Lino, Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., Zoccali, C., Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M.L., Roberts, I.S., Bellur, S., Cattran, D., Cook, T.H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Palma, A.M. De, Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Vecchio, L. Del, Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J.C., Wetzels, J.F.M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. Lino, Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., and Zoccali, C.

Abstract

Contains fulltext : 220672.pdf (Publisher’s version ) (Closed access), BACKGROUND: It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up. METHODS: In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1-10.8)]. RESULTS: In this extended analysis, M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%). CONCLUSION: Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.

Published
2020

5. Evaluating a New International Risk-Prediction Tool in IgA Nephropathy

Author

Barbour, Sean J., Coppo, Rosanna, Zhang, Hong, Liu, Zhi-Hong, Suzuki, Yusuke, Matsuzaki, Keiichi, Katafuchi, Ritsuko, Er, Lee, Espino-Hernandez, Gabriela, Kim, S. Joseph, Reich, Heather N., Feehally, John, Cattran, Daniel C., Russo, M. L., Troyanov, S., Cook, H. T., Roberts, I., Tesar, V., Maixnerova, D., Lundberg, S., Gesualdo, L., Emma, F., Fuiano, L., Beltrame, G., Rollino, C., Amore, A., Camilla, R., Peruzzi, L., Praga, M., Feriozzi, S., Polci, R., Segoloni, G., Colla, L., Pani, A., Piras, D., Angioi, A., Cancarini, G., Ravera, S., Durlik, M., Moggia, E., Ballarin, J., Di Giulio, S., Pugliese, F., Serriello, I., Caliskan, Y., Sever, M., Kilicaslan, I., Locatelli, F., Del Vecchio, L., Wetzels, J. F. M., Peters, H., Berg, U., Carvalho, F., da Costa Ferreira, A. C., Maggio, M., Wiecek, A., Ots-Rosenberg, M., Magistroni, R., Topaloglu, R., Bilginer, Y., D'Amico, M., Stangou, M., Giacchino, F., Goumenos, D., Kalliakmani, P., Gerolymos, M., Galesic, K., Geddes, C., Siamopoulos, K., Balafa, O., Galliani, M., Stratta, P., Quaglia, M., Bergia, R., Cravero, R., Salvadori, M., Cirami, L., Fellström, Bengt, Smerud, Hilde Kloster, Ferrario, F., Stellato, T., Egido, J., Martin, C., Floege, J., Eitner, F., Lupo, A., Bernich, P., Mene, R., Morosetti, M., van Kooten, C., Rabelink, T., Reinders, M. E. J., Boria Grinyo, J. M., Cusinato, S., Benozzi, L., Savoldi, S., Licata, C., Mizerska-Wasiak, M., Martina, G., Messuerotti, A., Dal Canton, A., Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Bellur, S., Mazzucco, G., Giannakakis, C., Honsova, E., Sundelin, B., Di Palma, A. M., Gutierrez, E., Asunis, A. M., Barratt, J., Tardanico, R., Perkowska-Ptasinska, A., Arce Terroba, J., Fortunato, M., Pantzaki, A., Ozluk, Y., Steenbergen, E., Soderberg, M., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Ljubanovic, D. Galesic, Gakiopoulou, H., Bertoni, E., Cannata Ortiz, P., Karkoszka, H., Groene, H. J., Stoppacciaro, A., Bajema, I., Bruijn, J., Fulladosa Oliveras, X., Maldyk, J., Loachim, E., Bavbek, N., Cook, T., Alpers, C., Berthoux, F., Bonsib, S., D'Agati, V, D'Amico, G., Emancipator, S., Emmal, F., Fervenza, F., Florquin, S., Fogo, A., Groene, H., Haas, M., Hill, P., Hogg, R., Hsu, S., Hunley, T., Hladunewich, M., Jennette, C., Joh, K., Julian, B., Kawamura, T., Lai, F., Leung, C., Li, L., Li, P., Liu, Z., Massat, A., Mackinnon, B., Mezzano, S., Schena, F., Tomino, Y., Walker, P., Wang, H., Weening, J., Yoshikawa, N., Zeng, Cai-Hong, Shi, Sufang, Nogi, C., Suzuki, H., Koike, K., Hirano, K., Yokoo, T., Hanai, M., Fukami, K., Takahashi, K., Yuzawa, Y., Niwa, M., Yasuda, Y., Maruyama, S., Ichikawa, D., Suzuki, T., Shirai, S., Fukuda, A., Fujimoto, S., Trimarchi, H., Barbour, Sean J., Coppo, Rosanna, Zhang, Hong, Liu, Zhi-Hong, Suzuki, Yusuke, Matsuzaki, Keiichi, Katafuchi, Ritsuko, Er, Lee, Espino-Hernandez, Gabriela, Kim, S. Joseph, Reich, Heather N., Feehally, John, Cattran, Daniel C., Russo, M. L., Troyanov, S., Cook, H. T., Roberts, I., Tesar, V., Maixnerova, D., Lundberg, S., Gesualdo, L., Emma, F., Fuiano, L., Beltrame, G., Rollino, C., Amore, A., Camilla, R., Peruzzi, L., Praga, M., Feriozzi, S., Polci, R., Segoloni, G., Colla, L., Pani, A., Piras, D., Angioi, A., Cancarini, G., Ravera, S., Durlik, M., Moggia, E., Ballarin, J., Di Giulio, S., Pugliese, F., Serriello, I., Caliskan, Y., Sever, M., Kilicaslan, I., Locatelli, F., Del Vecchio, L., Wetzels, J. F. M., Peters, H., Berg, U., Carvalho, F., da Costa Ferreira, A. C., Maggio, M., Wiecek, A., Ots-Rosenberg, M., Magistroni, R., Topaloglu, R., Bilginer, Y., D'Amico, M., Stangou, M., Giacchino, F., Goumenos, D., Kalliakmani, P., Gerolymos, M., Galesic, K., Geddes, C., Siamopoulos, K., Balafa, O., Galliani, M., Stratta, P., Quaglia, M., Bergia, R., Cravero, R., Salvadori, M., Cirami, L., Fellström, Bengt, Smerud, Hilde Kloster, Ferrario, F., Stellato, T., Egido, J., Martin, C., Floege, J., Eitner, F., Lupo, A., Bernich, P., Mene, R., Morosetti, M., van Kooten, C., Rabelink, T., Reinders, M. E. J., Boria Grinyo, J. M., Cusinato, S., Benozzi, L., Savoldi, S., Licata, C., Mizerska-Wasiak, M., Martina, G., Messuerotti, A., Dal Canton, A., Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Bellur, S., Mazzucco, G., Giannakakis, C., Honsova, E., Sundelin, B., Di Palma, A. M., Gutierrez, E., Asunis, A. M., Barratt, J., Tardanico, R., Perkowska-Ptasinska, A., Arce Terroba, J., Fortunato, M., Pantzaki, A., Ozluk, Y., Steenbergen, E., Soderberg, M., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Ljubanovic, D. Galesic, Gakiopoulou, H., Bertoni, E., Cannata Ortiz, P., Karkoszka, H., Groene, H. J., Stoppacciaro, A., Bajema, I., Bruijn, J., Fulladosa Oliveras, X., Maldyk, J., Loachim, E., Bavbek, N., Cook, T., Alpers, C., Berthoux, F., Bonsib, S., D'Agati, V, D'Amico, G., Emancipator, S., Emmal, F., Fervenza, F., Florquin, S., Fogo, A., Groene, H., Haas, M., Hill, P., Hogg, R., Hsu, S., Hunley, T., Hladunewich, M., Jennette, C., Joh, K., Julian, B., Kawamura, T., Lai, F., Leung, C., Li, L., Li, P., Liu, Z., Massat, A., Mackinnon, B., Mezzano, S., Schena, F., Tomino, Y., Walker, P., Wang, H., Weening, J., Yoshikawa, N., Zeng, Cai-Hong, Shi, Sufang, Nogi, C., Suzuki, H., Koike, K., Hirano, K., Yokoo, T., Hanai, M., Fukami, K., Takahashi, K., Yuzawa, Y., Niwa, M., Yasuda, Y., Maruyama, S., Ichikawa, D., Suzuki, T., Shirai, S., Fukuda, A., Fujimoto, S., and Trimarchi, H.

Abstract

Importance Although IgA nephropathy (IgAN) is the most common glomerulonephritis in the world, there is no validated tool to predict disease progression. This limits patient-specific risk stratification and treatment decisions, clinical trial recruitment, and biomarker validation. Objective To derive and externally validate a prediction model for disease progression in IgAN that can be applied at the time of kidney biopsy in multiple ethnic groups worldwide. Design, Setting, and Participants We derived and externally validated a prediction model using clinical and histologic risk factors that are readily available in clinical practice. Large, multi-ethnic cohorts of adults with biopsy-proven IgAN were included from Europe, North America, China, and Japan. Main Outcomes and Measures Cox proportional hazards models were used to analyze the risk of a 50% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease, and were evaluated using the R2D measure, Akaike information criterion (AIC), C statistic, continuous net reclassification improvement (NRI), integrated discrimination improvement (IDI), and calibration plots. Results The study included 3927 patients; mean age, 35.4 (interquartile range, 28.0-45.4) years; and 2173 (55.3%) were men. The following prediction models were created in a derivation cohort of 2781 patients: a clinical model that included eGFR, blood pressure, and proteinuria at biopsy; and 2 full models that also contained the MEST histologic score, age, medication use, and either racial/ethnic characteristics (white, Japanese, or Chinese) or no racial/ethnic characteristics, to allow application in other ethnic groups. Compared with the clinical model, the full models with and without race/ethnicity had better R2D (26.3% and 25.3%, respectively, vs 20.3%) and AIC (6338 and 6379, respectively, vs 6485), significant increases in C statistic from 0.78 to 0.82 and 0.81, respectively (ΔC, 0.04; 95% CI, 0.03-0.04 and ΔC, 0.03

Published
2019
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6. Risk factors for progression in children and young adults with IgA nephropathy: an analysis of 261 cases from the VALIGA European cohort

Author

Coppo, R., Lofaro, D., Camilla, R.R., Bellur, S., Cattran, D., Cook, H.T., Roberts, I.S., Peruzzi, L., Amore, A., Emma, F., Fuiano, L., Berg, U., Topaloglu, R., Bilginer, Y., Gesualdo, L., Polci, R., Mizerska-Wasiak, M., Caliskan, Y., Lundberg, S., Cancarini, G., Geddes, C., Wetzels, J., Wiecek, A., Durlik, M., Cusinato, S., Rollino, C., Maggio, M., Praga, M., Smerud, H.K., Tesar, V., Maixnerova, D., Barratt, J., Papalia, T., Bonofiglio, R., Mazzucco, G., Giannakakis, C., Soderberg, M., Orhan, D., Palma, A.M. De, Maldyk, J., Ozluk, Y., Sudelin, B., Tardanico, R., Kipgen, D., Steenbergen, E., Karkoszka, H., Perkowska-Ptasinska, A., Ferrario, F., Gutierrez, E., Honsova, E., Coppo, R., Lofaro, D., Camilla, R.R., Bellur, S., Cattran, D., Cook, H.T., Roberts, I.S., Peruzzi, L., Amore, A., Emma, F., Fuiano, L., Berg, U., Topaloglu, R., Bilginer, Y., Gesualdo, L., Polci, R., Mizerska-Wasiak, M., Caliskan, Y., Lundberg, S., Cancarini, G., Geddes, C., Wetzels, J., Wiecek, A., Durlik, M., Cusinato, S., Rollino, C., Maggio, M., Praga, M., Smerud, H.K., Tesar, V., Maixnerova, D., Barratt, J., Papalia, T., Bonofiglio, R., Mazzucco, G., Giannakakis, C., Soderberg, M., Orhan, D., Palma, A.M. De, Maldyk, J., Ozluk, Y., Sudelin, B., Tardanico, R., Kipgen, D., Steenbergen, E., Karkoszka, H., Perkowska-Ptasinska, A., Ferrario, F., Gutierrez, E., and Honsova, E.

Abstract

Item does not contain fulltext

Published
2017

7. Risk factors for progression in children and young adults with IgA nephropathy: an analysis of 261 cases from the VALIGA European cohort

Author

Coppo, R., Lofaro, D., Camilla, R.R., Bellur, S., Cattran, D., Cook, H.T., Roberts, I.S., Peruzzi, L., Amore, A., Emma, F., Fuiano, L., Berg, U., Topaloglu, R., Bilginer, Y., Gesualdo, L., Polci, R., Mizerska-Wasiak, M., Caliskan, Y., Lundberg, S., Cancarini, G., Geddes, C., Wetzels, J., Wiecek, A., Durlik, M., Cusinato, S., Rollino, C., Maggio, M., Praga, M., Smerud, H.K., Tesar, V., Maixnerova, D., Barratt, J., Papalia, T., Bonofiglio, R., Mazzucco, G., Giannakakis, C., Soderberg, M., Orhan, D., Palma, A.M. De, Maldyk, J., Ozluk, Y., Sudelin, B., Tardanico, R., Kipgen, D., Steenbergen, E., Karkoszka, H., Perkowska-Ptasinska, A., Ferrario, F., Gutierrez, E., Honsova, E., Coppo, R., Lofaro, D., Camilla, R.R., Bellur, S., Cattran, D., Cook, H.T., Roberts, I.S., Peruzzi, L., Amore, A., Emma, F., Fuiano, L., Berg, U., Topaloglu, R., Bilginer, Y., Gesualdo, L., Polci, R., Mizerska-Wasiak, M., Caliskan, Y., Lundberg, S., Cancarini, G., Geddes, C., Wetzels, J., Wiecek, A., Durlik, M., Cusinato, S., Rollino, C., Maggio, M., Praga, M., Smerud, H.K., Tesar, V., Maixnerova, D., Barratt, J., Papalia, T., Bonofiglio, R., Mazzucco, G., Giannakakis, C., Soderberg, M., Orhan, D., Palma, A.M. De, Maldyk, J., Ozluk, Y., Sudelin, B., Tardanico, R., Kipgen, D., Steenbergen, E., Karkoszka, H., Perkowska-Ptasinska, A., Ferrario, F., Gutierrez, E., and Honsova, E.

Abstract

Item does not contain fulltext

Published
2017

8. Risk factors for progression in children and young adults with IgA nephropathy: an analysis of 261 cases from the VALIGA European cohort

Author

Coppo, R., Lofaro, D., Camilla, R.R., Bellur, S., Cattran, D., Cook, H.T., Roberts, I.S., Peruzzi, L., Amore, A., Emma, F., Fuiano, L., Berg, U., Topaloglu, R., Bilginer, Y., Gesualdo, L., Polci, R., Mizerska-Wasiak, M., Caliskan, Y., Lundberg, S., Cancarini, G., Geddes, C., Wetzels, J., Wiecek, A., Durlik, M., Cusinato, S., Rollino, C., Maggio, M., Praga, M., Smerud, H.K., Tesar, V., Maixnerova, D., Barratt, J., Papalia, T., Bonofiglio, R., Mazzucco, G., Giannakakis, C., Soderberg, M., Orhan, D., Palma, A.M. De, Maldyk, J., Ozluk, Y., Sudelin, B., Tardanico, R., Kipgen, D., Steenbergen, E., Karkoszka, H., Perkowska-Ptasinska, A., Ferrario, F., Gutierrez, E., Honsova, E., Coppo, R., Lofaro, D., Camilla, R.R., Bellur, S., Cattran, D., Cook, H.T., Roberts, I.S., Peruzzi, L., Amore, A., Emma, F., Fuiano, L., Berg, U., Topaloglu, R., Bilginer, Y., Gesualdo, L., Polci, R., Mizerska-Wasiak, M., Caliskan, Y., Lundberg, S., Cancarini, G., Geddes, C., Wetzels, J., Wiecek, A., Durlik, M., Cusinato, S., Rollino, C., Maggio, M., Praga, M., Smerud, H.K., Tesar, V., Maixnerova, D., Barratt, J., Papalia, T., Bonofiglio, R., Mazzucco, G., Giannakakis, C., Soderberg, M., Orhan, D., Palma, A.M. De, Maldyk, J., Ozluk, Y., Sudelin, B., Tardanico, R., Kipgen, D., Steenbergen, E., Karkoszka, H., Perkowska-Ptasinska, A., Ferrario, F., Gutierrez, E., and Honsova, E.

Abstract

Item does not contain fulltext

Published
2017

9. Tonsillectomy in a European Cohort of 1,147 Patients with IgA Nephropathy

Author

Feehally, J., Coppo, R., Troyanov, S., Bellur, S.S., Cattran, D., Cook, T., Roberts, I.S., Verhave, J.C., Camilla, R., Vergano, L., Egido, J., Wiecek, A., Karkoszka, H., Tesar, V., Maixnerova, D., Ots-Rosenberg, M., Quaglia, M., Rollino, C., Magistroni, R., Cusinato, S., Cravero, R., Peruzzi, L., Lundberg, S., Gesualdo, L., Cancarini, G., Feriozzi, S., Ferrario, F., Feehally, J., Coppo, R., Troyanov, S., Bellur, S.S., Cattran, D., Cook, T., Roberts, I.S., Verhave, J.C., Camilla, R., Vergano, L., Egido, J., Wiecek, A., Karkoszka, H., Tesar, V., Maixnerova, D., Ots-Rosenberg, M., Quaglia, M., Rollino, C., Magistroni, R., Cusinato, S., Cravero, R., Peruzzi, L., Lundberg, S., Gesualdo, L., Cancarini, G., Feriozzi, S., and Ferrario, F.

Abstract

Item does not contain fulltext, BACKGROUND: Tonsillectomy has been considered a treatment for IgA nephropathy (IgAN). It is aimed at removing a source of pathogens, reducing mucosa-associated lymphoid tissue and decreasing polymeric IgA synthesis. However, its beneficial effect is still controversial. In Asia, favorable outcomes have been claimed mostly in association with corticosteroids. In Europe, small, single-center uncontrolled studies have failed to show benefits. METHODS: The European validation study of the Oxford classification of IgAN (VALIGA) collected data from 1,147 patients with IgAN over a follow-up of 4.7 years. We investigated the outcome of progression to end-stage renal disease (ESRD) and/or 50% loss of estimated glomerular filtration rate (eGFR) and the annual loss of eGFR in 61 patients who had had tonsillectomy. RESULTS: Using the propensity score, which is a logistic regression model, we paired 41 patients with tonsillectomy and 41 without tonsillectomy with similar risk of progression (gender, age, race, mean blood pressure, proteinuria, eGFR at renal biopsy, previous treatments and Oxford MEST scores). No significant difference was found in the outcome. Moreover, we performed an additional propensity score pairing 17 patients who underwent tonsillectomy after the diagnosis of IgAN and 51 without tonsillectomy with similar risk of progression at renal biopsy and subsequent treatments. No significant difference was found in changes in proteinuria, or in the renal end point of 50% reduction in GFR and/or ESRD, or in the annual loss of eGFR. CONCLUSION: In the large VALIGA cohort of European subjects with IgAN, no significant correlation was found between tonsillectomy and renal function decline.

Published
2016

10. Tonsillectomy in a European Cohort of 1,147 Patients with IgA Nephropathy

Author

Feehally, J., Coppo, R., Troyanov, S., Bellur, S.S., Cattran, D., Cook, T., Roberts, I.S., Verhave, J.C., Camilla, R., Vergano, L., Egido, J., Wiecek, A., Karkoszka, H., Tesar, V., Maixnerova, D., Ots-Rosenberg, M., Quaglia, M., Rollino, C., Magistroni, R., Cusinato, S., Cravero, R., Peruzzi, L., Lundberg, S., Gesualdo, L., Cancarini, G., Feriozzi, S., Ferrario, F., Feehally, J., Coppo, R., Troyanov, S., Bellur, S.S., Cattran, D., Cook, T., Roberts, I.S., Verhave, J.C., Camilla, R., Vergano, L., Egido, J., Wiecek, A., Karkoszka, H., Tesar, V., Maixnerova, D., Ots-Rosenberg, M., Quaglia, M., Rollino, C., Magistroni, R., Cusinato, S., Cravero, R., Peruzzi, L., Lundberg, S., Gesualdo, L., Cancarini, G., Feriozzi, S., and Ferrario, F.

Abstract

Item does not contain fulltext, BACKGROUND: Tonsillectomy has been considered a treatment for IgA nephropathy (IgAN). It is aimed at removing a source of pathogens, reducing mucosa-associated lymphoid tissue and decreasing polymeric IgA synthesis. However, its beneficial effect is still controversial. In Asia, favorable outcomes have been claimed mostly in association with corticosteroids. In Europe, small, single-center uncontrolled studies have failed to show benefits. METHODS: The European validation study of the Oxford classification of IgAN (VALIGA) collected data from 1,147 patients with IgAN over a follow-up of 4.7 years. We investigated the outcome of progression to end-stage renal disease (ESRD) and/or 50% loss of estimated glomerular filtration rate (eGFR) and the annual loss of eGFR in 61 patients who had had tonsillectomy. RESULTS: Using the propensity score, which is a logistic regression model, we paired 41 patients with tonsillectomy and 41 without tonsillectomy with similar risk of progression (gender, age, race, mean blood pressure, proteinuria, eGFR at renal biopsy, previous treatments and Oxford MEST scores). No significant difference was found in the outcome. Moreover, we performed an additional propensity score pairing 17 patients who underwent tonsillectomy after the diagnosis of IgAN and 51 without tonsillectomy with similar risk of progression at renal biopsy and subsequent treatments. No significant difference was found in changes in proteinuria, or in the renal end point of 50% reduction in GFR and/or ESRD, or in the annual loss of eGFR. CONCLUSION: In the large VALIGA cohort of European subjects with IgAN, no significant correlation was found between tonsillectomy and renal function decline.

Published
2016

11. Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments

Author

Coppo, Rosanna, Troyanov, Stéphan, Bellur, Shubha, Cattran, Daniel, Cook, H. Terence, Feehally, John, Roberts, Ian S.D., Morando, Laura, Camilla, Roberta, Tesar, Vladimir, Lunberg, Sigrid, Gesualdo, Loreto, Emma, Francesco, Rollino, Cristiana, Amore, Alessandro, Praga, Manuel, Feriozzi, Sandro, Segoloni, Giuseppe, Pani, Antonello, Cancarini, Giovanni, Durlik, Magalena, Moggia, Elisabetta, Mazzucco, Gianna, Giannakakis, Costantinos, Honsova, Eva, Sundelin, B. Brigitta, Palma, Anna Maria Di, Ferrario, Franco, Gutierrez, Eduardo, Asunis, Anna Maria, Barratt, Jonathan, Tardanico, Regina, Perkowska-Ptasinska, Agnieszka, Maixnerova, D., Lundberg, S., Fuiano, L., Beltrame, G., Peruzzi, L., Polci, R., Colla, L., Angioi, A., Piras, D., Ravera, S., Ballarin, J., Di Giulio, S., Pugliese, F., Caliskan, Y., Locatelli, F., Del Vecchio, L., Wetzels, J. F.M., Peters, H., Berg, U., Carvalho, F., Maggio, M., Wiecek, A., Ots-Rosenberg, M., Magistroni, R., Topaloglu, R., Bilginer, Y., D'Amico, M., Stangou, M., Giacchino, F., Goumenos, D., Kalliakmani, P., Gerolymos, M., Galesic, K., Geddes, C., Siamopoulos, K., Balafa, O., Galliani, M., Stratta, P., Quaglia, M., Bergia, R., Cravero, R., Salvadori, M., Cirami, L., Fellstrom, B., Kloster Smerud, H., Stellato, T., Egido, J., Martin, C., Floege, J., Eitner, F., Lupo, A., Bernich, P., Menè, P., Morosetti, M., Van Kooten, C., Rabelink, T., Reinders, M. E.J., Boria Grinyo, J. M., Cusinato, S., Benozzi, L., Savoldi, S., Licata, C., Mizerska Wasiak, M., Martina, G., Messuerotti, A., Dal Canton, A., Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Ferrario, F., Gutiérrez, E., Arce Terroba, J., Fortunato, M., Ozluk, Y., Kilicaslan, I., Steenberger, E., Soderberg, M., Da Costa Ferreira, A. C., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Galesic Ljubanovic, D., Bertoni, E., Cannata Ortiz, P., Groene, H. J., Stoppacciaro, A., Bajema, I., Bruijn, J., Fulladosa Oliveras, X., Maldyk, J., Ioachim, E., Coppo, Rosanna, Troyanov, Stéphan, Bellur, Shubha, Cattran, Daniel, Cook, H. Terence, Feehally, John, Roberts, Ian S.D., Morando, Laura, Camilla, Roberta, Tesar, Vladimir, Lunberg, Sigrid, Gesualdo, Loreto, Emma, Francesco, Rollino, Cristiana, Amore, Alessandro, Praga, Manuel, Feriozzi, Sandro, Segoloni, Giuseppe, Pani, Antonello, Cancarini, Giovanni, Durlik, Magalena, Moggia, Elisabetta, Mazzucco, Gianna, Giannakakis, Costantinos, Honsova, Eva, Sundelin, B. Brigitta, Palma, Anna Maria Di, Ferrario, Franco, Gutierrez, Eduardo, Asunis, Anna Maria, Barratt, Jonathan, Tardanico, Regina, Perkowska-Ptasinska, Agnieszka, Maixnerova, D., Lundberg, S., Fuiano, L., Beltrame, G., Peruzzi, L., Polci, R., Colla, L., Angioi, A., Piras, D., Ravera, S., Ballarin, J., Di Giulio, S., Pugliese, F., Caliskan, Y., Locatelli, F., Del Vecchio, L., Wetzels, J. F.M., Peters, H., Berg, U., Carvalho, F., Maggio, M., Wiecek, A., Ots-Rosenberg, M., Magistroni, R., Topaloglu, R., Bilginer, Y., D'Amico, M., Stangou, M., Giacchino, F., Goumenos, D., Kalliakmani, P., Gerolymos, M., Galesic, K., Geddes, C., Siamopoulos, K., Balafa, O., Galliani, M., Stratta, P., Quaglia, M., Bergia, R., Cravero, R., Salvadori, M., Cirami, L., Fellstrom, B., Kloster Smerud, H., Stellato, T., Egido, J., Martin, C., Floege, J., Eitner, F., Lupo, A., Bernich, P., Menè, P., Morosetti, M., Van Kooten, C., Rabelink, T., Reinders, M. E.J., Boria Grinyo, J. M., Cusinato, S., Benozzi, L., Savoldi, S., Licata, C., Mizerska Wasiak, M., Martina, G., Messuerotti, A., Dal Canton, A., Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Ferrario, F., Gutiérrez, E., Arce Terroba, J., Fortunato, M., Ozluk, Y., Kilicaslan, I., Steenberger, E., Soderberg, M., Da Costa Ferreira, A. C., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Galesic Ljubanovic, D., Bertoni, E., Cannata Ortiz, P., Groene, H. J., Stoppacciaro, A., Bajema, I., Bruijn, J., Fulladosa Oliveras, X., Maldyk, J., and Ioachim, E.

Abstract

The Oxford Classification of IgA Nephropathy (IgAN) identified mesangial hypercellularity (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T) as independent predictors of outcome. Whether it applies to individuals excluded from the original study and how therapy influences the predictive value of pathology remain uncertain. The VALIGA study examined 1147 patients from 13 European countries that encompassed the whole spectrum of IgAN. Over a median follow-up of 4.7 years, 86% received renin-angiotensin system blockade and 42% glucocorticoid/immunosuppressive drugs. M, S, and T lesions independently predicted the loss of estimated glomerular filtration rate (eGFR) and a lower renal survival. Their value was also assessed in patients not represented in the Oxford cohort. In individuals with eGFR less than 30 ml/min per 1.73 m 2, the M and T lesions independently predicted a poor survival. In those with proteinuria under 0.5 g/day, both M and E lesions were associated with a rise in proteinuria to 1 or 2 g/day or more. The addition of M, S, and T lesions to clinical variables significantly enhanced the ability to predict progression only in those who did not receive immunosuppression (net reclassification index 11.5%). The VALIGA study provides a validation of the Oxford classification in a large European cohort of IgAN patients across the whole spectrum of the disease. The independent predictive value of pathology MEST score is reduced by glucocorticoid/immunosuppressive therapy.

Published
2014

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